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Home My WebLink AboutBlde-20-000704 or Commonwealth of Official Use Only Massachusetts Permit No. BLDE-20-000704 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.1/07] APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:8/6/2019 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm the electncal work described below. Location(Street&Number) 41 CAPT WRIGHT RD Owner or Tenant HEBARD ELIZABETH A(LIFE EST) Telephone No. Owner's Address CIO ANTONITIS DEIRDRE F,41 CAPT WRIGHT RD,SOUTH YARMOUTH, MA 02664 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. 2353597 Existing Service 100 Amps Volts Overhead 0 Undgrd 0 No.of Meters New Service 100 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Upgrade service&install surge protector. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above 0 In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: 1 Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: _ (When required by municipal policy.) Work to start: Inspection to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE:Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent.The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE:INSURANCE 0 BOND 0 OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: SANDY I MCLARDY Licensee: SANDY I MCLARDY Signature LIC.NO.: 51160 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:608 MAPLE AVE, EWING NJ 08618 Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: OWNER'S INSURANCE WAIVER:I am aware that the License does not have the liability insurance coverage normally required by law.But signature below,I hereby waive this requirement.I am the(check one) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $50.00 9 *) Ica d COMOSOMIlta[Ih of i�ta66aci�u�atl3 Official Use Only in___ �ad r 070`T -'�i= = ep / C� Permit No. of Serviced i_ r=,= '• ' Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 (leave blank) •-•-- -----M•-T.- APPLICATION FOR-PERMIT TO PERFORM ELECTRICAL WORK i 1. z ! All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 i tali1 MA ( ' E PRINT IN INK OR TYPE ALL INFORTIOA9 Date: i>' � Cityor Town of: M YAROUTH To the Inspector of Wires: `v oB this applic ation cation the pndersigned gives notice of his or her intention to perform,the electrical work described below. uj - 'EL. .tion (Street&Number) 1 C..) r 0 t 7 i • ner or Tenant 1 9 , e li r) e e�,k r c� Telephone No. O 76 (et 7.2 LU ME �•��er's Address � Is ,is permit in conjunction with a building permit? Yes ❑ No . {Er (Check Appropriate Box) Purpose of Building Utility Authorization No. 3 S i .1' Existing Service 100 Amps / Volts Overhead 0 Undgrd❑ No.of Meters — New Service (0 0 Amps I ()-G'/a-1I0 Volts Overhead PI Undgrd ❑ No.of Meters / Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 0_,_eip I c e r f ' S 'Kv l,c e vs..; -I 1{ Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cetl.-Susp.(Paddle)Fans No.of Total Transformers KVA _ No. of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- No.of It mergency Lighting - - _rnd. grnd. ❑ Battery Units No.of Receptacle Outlets 1 No.of Oil Burners FIRE ALARMS 1No.of Zones No.of Switches No.of Gas Burners 'No.of Detection and - 0 Initiating Devices No.of Ranges No.of Air Cond. Total - V Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number 'Tons I KW No.of Self-Contained Totals: f f Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW al❑ Municipal Connection ❑ Other No.of Dryers Heating Appliances No.of , Security Systems:* No.of Water No.of Devices or Equivalent `� Heaters KWNo.of Data Wiring: - Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: whole Gt/ (� C✓S C S�ci r5 Jic� Pc �G/ • `� j Attach additional detail if desired or as required by the Inspector of Wirer. Estimated Value of Electrical Work j 7 Co (When required by municipal policy.) Work to Start . 6— i of Inspections to be requested in accordance with MEC Rule 10,and upon completion. , S9 INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. mess undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE g BOND 0 OTHER 0 (Specify.) I certify, under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: e LIC.NO.: 2_6.-- Licensee: Signature V") (If applicable,enter"exempt in the license numb line.) LIC.NO.:-- —� Address: Bus.Tel.No.: �7 :l l s�' �c 5 g O ,J • `Per M.G.L.c. 147,s.57-61,security work requires Department of Public SafetyAlt.Tel.No.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage norrtly 5 required by law. By my signature below,I hereby waive this requirement. I am the(check one ❑owner o Owner/Agent ❑owner's a ent Signature. Telephone No. PERMIT FEE: $ brb —